By Merin C. MacDonald
The Center for Digital Health Solutions (CDHS) is a new initiative at UMass Memorial Health that builds and implements intelligent digital health solutions which enable measurable change and make health care delivery more efficient and accessible. Under the leadership of Michael Hyder, MD, MPH, executive director of the CDHS and associate professor of medicine, and supported by Joyce Simon, CITC senior strategic project manager, the initiative encourages and supports providers to find innovative approaches to patient care that improve outcomes through various core programs including the Advanced Therapeutics Program (ATRx).
The Advanced Therapeutics Program enables patients living with chronic diseases greater access to life-changing, next-generation therapies through groundbreaking approaches that bridge a current, critical gap in care. The Advanced Therapeutics team identifies patients that might benefit from targeted interventions through advanced analytic tools which create complex queries of data to ask specific questions of the Electronic Health Record (EHR). Those questions are related to criteria needed to initiate beneficial therapies that are critical to improving patient health and wellness.
Currently, the Advanced Therapeutics Program is being implemented with a focus on patients with cardiometabolic and osteoporosis diseases. This highly collaborative effort integrates specialty medicine into primary care and heavily relies on discussion and consultation with both primary care providers and specialists. The program is meant to optimize patient care and support primary care in some of their most complex cases. After patients are identified through advanced analytics, Sandy Aiello, ACNP, the lead cardiometabolic APP, reviews the EHR and consults virtually and directly with the physician specialist team including, Madona Azar, MD (Endo-DM), Matthew Niemi, MD (Renal), Kostya Abramov, MD (Renal), and Khanh-Van Tran, MD, PhD (Cardiology). The team runs cardiometabolic rounds where they discuss approximately five cases each week for patients that may be good candidates for groundbreaking drugs and therapies that would typically be prescribed by specialists after an in-person visit. These weekly virtual meetings help facilitate efficient case reviews, recommendations, and prompt implementation when appropriate. Ms. Aiello then works with primary care providers and patients through all steps of the process from a discussion about the drug that may be of benefit, to prescribing, subsequent labs, and follow-up on possible side effects. In addition to working collaboratively with providers, she works closely with the UMass Memorial Specialty Pharmacy on everything from prior authorizations to insurance co-pays, often working with them to significantly lower co-pays to lessen the financial strain on patients. Along with the cardiometabolic initiative, the Advanced Therapeutics Program is also currently being implemented with osteoporosis patients under the clinical supervision of Jonathan Cheah, MD (Rheumatology).
Having launched with cardiometabolic patients in early 2023, the Advanced Therapeutics Program has already had a remarkable impact on UMass patients. In just over six weeks, this program has greatly benefitted over 30 lives. Karen Peterson, MD, division chief of Tri-River Medicine and associate professor of medicine, recently commented on the benefits of the Advanced Therapeutics Program to their patients: “Tri-River’s experience with the new Advanced Therapeutics program for GLP-1, SGLT2, and PCSK9 inhibitors has been a tremendous benefit for our patients and relieved a prior approval burden on our staff. The patients are identified through EPIC or referred by us to Advanced Practitioner Sandy Aiello. After reviewing the case with a multidisciplinary group (including Endocrine, Cardiology, and Renal), the patients are scheduled for a telehealth visit to discuss the benefits of the medications and potential side effects. [Ms. Aiello] processes the insurance prior approval paperwork for the appropriate medication and follows up with the patients. The medications are sent directly to the patient from the UMass Pharmacy. This has been a fabulous step forward for our patients! We are finally able to get patients the medications we know they need to improve their cardiovascular and renal health. Thank you Advanced Therapeutics!”
Indeed, Ms. Aiello is passionate about and dedicated to the patients she cares for and her work has had a significant impact on the successful launch and implementation of the Advanced Therapeutics Program. She joined UMass in 2014 and worked in inpatient cardiology and then as part of the Medical ICU APP staff during the pandemic, before joining the cardiometabolic program. On joining Advanced Therapeutics she remarked, “I was enamored with the possibility of a multidisciplinary approach to cardiometabolic disease and the role of e-medicine.” Ms. Aiello noted that patients are incredibly grateful to be receiving medications that are finally easing the burden of their chronic illness and to have support on insurance matters. This program has truly been life-changing to some of the patients and has great potential as it continues to grow into other service areas.
In the future, the hope is that this program will be accessible to all primary care providers and specialists throughout UMass Memorial Medical Group. "We started here because of the devastating impact these diseases have on our patients’ health and the opportunity to help our PCPs slow the progression of their conditions. Through these collaborative efforts, we can prevent long-term suffering and improve the health and well-being of the people in the communities we serve. Our amazing ATRx team is already making an impact and I’m so proud of their efforts,” commented Dr. Hyder.